Sustainable Healthcare Services Research Articles

A ATUAÇÃO DO FARMACÊUTICO NO GERENCIAMENTO DE RESÍDUOS SÓLIDOS EM LABORATÓRIO DE ANÁLISES CLÍNICAS

Abstract: The management of solid waste in clinical laboratories is essential to ensure the safety of workers, public health, and environmental preservation. Pharmacists play a key role in this process, being responsible for overseeing the segregation, storage, and proper disposal of biological, chemical, and sharps waste. In addition, they must implement biosafety protocols, train the team, and monitor performance indicators related to waste management. Among the main challenges faced are the lack of infrastructure for hazardous waste disposal and the need for greater awareness among professionals. The pharmacist’s role in waste management contributes to compliance with current regulations and the sustainability of healthcare services.

A hybrid multi-criteria decision-making approach for hospital sustainability performance assessment

PurposeNowadays, the sustainability of healthcare services is of increasing importance. In particular, hospitals have ceased to be only treatment-oriented institutions and have begun to operate on the principles of sustainability in their environmental, economic and social dimensions. In this context, a comprehensive method is required to evaluate and improve the performance of hospitals.Design/methodology/approachIn this study, it is recommended to combine D-DEMATEL (D number theory and decision-making trial and evaluation laboratory methods) and objectives matrix (OMAX) methods, which are two important methods in determining hospital performance. D-DEMATEL is a technique used to analyze complex relationships and interactions that reduces subjective judgments because it is based on the opinions of many decision-makers and can be applied even in cases of incomplete information. OMAX, on the other hand, provides a comprehensive framework for measuring performance and allows different performance indicators to be evaluated together.FindingsThe novel performance assessment model is applied to a hospital in real life. Its performance value, according to 36 determined performance indicators, is calculated at 56.91%. The indicators of the hospital that need improvement are defined by the traffic light system method. The performance indicator importance ranking of D-DEMATEL is compared to the ranking obtained by the fuzzy DEMATEL method.Originality/value Important indicators to be used in later sustainable hospital performance evaluation studies were determined. Also, an integrated D-DEMATEL and OMAX method for evaluating sustainable hospital performance is presented.

Sustainable Healthcare in China: Analysis of User Satisfaction, Reuse Intention, and Electronic Word-of-Mouth for Online Health Service Platforms

Online health service (OHS) platforms can provide sustainable healthcare services in China where healthcare demand continues to grow along with the scarcity of healthcare resources. This study investigated the levels of satisfaction of Chinese consumers’ experiences with OHS platforms and their reuse and electronic word-of-mouth (e-WOM) recommendation intentions. This study provides data for educating consumers on OHS platforms and for guiding strategic business planning for the OHS market. The theoretical model applied was the theory of planned behavior, augmented by integrating factors such as perceived service quality and subjective knowledge into its framework. Data were collected in April 2024 through an online survey of Chinese consumers who had used OHS platforms in the past year. The data were assessed using structural equation modeling and multiple group analysis. The findings indicate that various factors, including attitudes, perceived interaction quality, behavioral control, perceived system quality, perceived information quality, and subjective knowledge concerning OHS platforms, are significant enhancers of user satisfaction and reuse and e-WOM intentions. Health consciousness is a moderating variable in the dynamics between consumer satisfaction and their propensity to engage in e-WOM. Strategies targeting factors that influence satisfaction require development.

Perceived Public Participation and Health Delivery in Local Government Districts in Uganda.

Citizen participation is a crucial aspect of the national health system, empowering individuals to contribute to improving local health services through Health Committees (HCs). HCs promote the participation of citizens in the delivery of primary healthcare services. The study explores the perceptions of citizen participation in the context of the Ruhama County Ntungamo local government area, Uganda. This study aims to understand the impact of HCs on healthcare service delivery. Using a qualitative approach of inquiry grounded in thematic analysis and rooted in principal-agent theory in a single case study, this study examined citizens' participation in the delivery of a local healthcare service. The study is based on interviews with 66 participants comprising health workers, patients, residents, health administrators, local councillors, and HC members. The findings reveal a notable absence of a health committee in healthcare delivery in Ruhama County. The absence is attributed to a need for a formalised citizen participation structure in managing health facilities and service delivery. It raises concerns about the limited influence of citizens in shaping healthcare policies and decision-making processes. The study recommends the incorporation of health committees into the local health systems to enhance participation and grant communities greater influence over the management of health facilities and service delivery. Incorporating health committees into local health systems strengthens citizen participation and leads to more effective and sustainable healthcare services aligned with people's needs and preferences. Integrating health committees within Itojo Hospital and similar facilities can grant citizens a meaningful role in shaping the future of their healthcare.

A prediction framework for pharmaceutical drug consumption using short time-series

The increasing pharmaceutical expenditure in many countries has raised concerns regarding the sustainability of healthcare services. To address this issue, accurate forecasting of pharmaceutical demand is crucial for healthcare planning and policy development. This paper proposes a novel prediction framework that integrates different types of historical data and simulates a part of the generative process that produces pharmaceutical consumption, considering both exogenous and endogenous factors, such as per capita consumption trends and population dynamics. The output of the framework is a distribution of likely values, enabling the use not only of the central value for making a prediction but also of the explicitly stated uncertainty, which is crucial for decision-makers in such a critical and complex context. The reliability and consistency of the framework are ensured through backtesting and comparing the predicted results with actual data.

Analyzing Primary Healthcare Governance in Indonesia: Perspectives of Community Health Workers.

Background Community-integrated health posts (Posyandu) are crucial for extending primary healthcare across diverse geographical and demographic landscapes in Indonesia. Community health workers (CHWs) currently function as the main service delivery actors for Posyandu. However, Posyandu's performance remains below the standards set by the Ministry of Health. This study examines health system determinants that explain the poor performance of Posyandu and, in particular, examines the roles of village and township governance and community health center management in supporting the effectiveness of primary healthcare programs. Methodology We analyzed 638 Posyandus across 13 Indonesian provinces, utilizing data from the 2014 Indonesia Family Life Survey. We evaluated eight health system determinants based on the perceptions of CHWs concerning challenges encountered in Posyandus. These factors were ranked and analyzed to determine the variables that affected Posyandu's poor performance. Both unadjusted and adjusted odds ratios were calculated. Results This study revealed that nearly half of the Posyandus in Indonesia are underperforming, particularly in rural areas. Common challenges include insufficient funds, inadequate equipment, and a lack of permanent buildings. Although only a small percentage mentioned minimal support from village and Puskesmas authorities, the weak governance roles of village heads are reflected in all the concerns mentioned by CHWs. Conclusions The absence of village heads from governance roles has contributed to Posyandu's operational problems as perceived by CHWs. Community health centers (Puskesmas), responsible for providing technical support to Posyandu, should be part of CHW teams and networks. Further discussions are needed to choose a workable governance model to ensure practical, accessible, and sustainable primary healthcare services at the grassroots level.

Sustainable Young Nursing Business Manager Leadership Competency: The Philippines Experience

The global shortage of qualified nurse managers, particularly evident in the Philippines, is rooted in the absence of training programs for transitioning nurses into management roles. Recent studies highlight this gap, leading to the promotion of inexperienced nurses to leadership positions and resulting in ineffective management practices and compromised care quality. Recognizing the importance of sustainable leadership competency for the long-term viability of healthcare services, a study in Metro Manila seeks to address these issues. The research focuses on gathering insights from nursing business experts regarding essential skills for sustainable leadership among young nursing business managers. The study aims to not only explore these perspectives but also assess the competency levels of young nurse managers using a newly developed survey tool. The objectives encompass determining expert views on necessary skills, profiling participants based on demographic factors, assessing competency levels, and drawing recommendations from the mixed-methods study results. Employing a mixed-method approach, the study initially conducted interviews with nursing business leaders in Manila. The themes derived from these interviews were then utilized in formulating the questionnaire. The findings revealed demographic variations among participants, influencing their responses. Five major themes emerged, reflecting participant perspectives on the competency of young nurse business managers: professional conduct, educational competency, individual assessment, trans-cultural competency, and informatics tech competency. In conclusion, the study emphasizes the diverse skills and competencies required by young nurse business leaders for effective functioning in occupational and professional settings. These competencies, spanning professional conduct, individual assessment, cultural competence, and technological proficiency, are deemed critical components in assessing and evaluating the effectiveness and efficiency of young nursing leaders, as emphasized in the existing literature. The study underscores the imperative for comprehensive training programs to enhance the competency of young nursing leaders, contributing to the overall quality and sustainability of healthcare services. Keywords: Nursing, leadership, Management, Concepts Investigated: professional conduct, individual assessment, culturally-inclined competency, informatics tech competency, educational competencies, Exploratory sequential Mixed-method , purposive sampling , The Philippines, South East Asia

A survey of the NHS reporting radiographer workforce in England

Introduction: At present there is no national register of the population size and scope of reporting radiographers in England. This makes operational workforce and succession planning for sustainable healthcare services in the National Health Service England (NHSE) difficult, affecting implementing NHSE policies and priorities such as 50% of X-rays reported by reporting radiographers and decreasing reporting Turnaround Times (TATs). This survey aimed to establish the workforce population employed as reporting radiographers in NHSE. Methods: An online anonymous seven question survey was distributed on social media and at the UK Imaging and Oncology Congress. Participant criteria included NHSE radiology staff (diagnostic radiographer, reporting radiographer, radiology manager, imaging superintendent modality lead, consultant radiologist, etc.) or a student diagnostic radiographer working within an NHSE trust. The survey recorded the participant's NHSE region (North Western, North Eastern and Yorkshire, Midlands, East of England, London, South Eastern and South Western regions), Integrated Care Systems (ICS), NHSE Trust, hospital, the amount of reporting radiographers and trainees employed, the Agenda for Change (AfC) job banding and imaging modality reported (X-ray, CT, MRI, NM, PET, DEXA). The data analysis applied descriptive statistics for estimating patterns and trends in the distrubtion of data (English region, AfC banding and imaging modality). Results: Responses were received from all seven of the NHSE regions (n=36/43 ICSs). The data demonstrated a larger workforce in the north of England than in the south, with employment at a range of AfC bandings from 5-8. The imaging modalities reported by radiographers in England demonstrated X-ray (n=34), the most reported imaging examination by region, and Nuclear Medicine (n=3) the least, with evidence of clinical reporting for CT (n=20), MRI (n=18), DEXA (n=16), Mammography (n=13) and fluoroscopy (n=12) being completed by radiographers in England. Conclusion: The findings for England (n=704 reporters; n=142 trainees) provide an estimate based on the response rate of the current reporting radiographer workforce across the NHSE regions, and their contribution to the skills mix radiology reporting service delivery. It is hoped future surveys will provide ongoing workforce estimates for the diagnostic radiographer reporting workforce in NHSE to support workforce transformation and sustainability plans for the radiography profession and to meet government healthcare targets and priorities.

Factors Influencing Adoption of Blockchain Technology in Jordan: The Perspective of Health Care Professionals

Aim/Purpose: This paper investigates the user acceptability of blockchain technology in the healthcare sector, with a specific focus on healthcare professionals in Jordan. Background: The study seeks to identify the factors that affect healthcare professionals’ use and acceptance of blockchain technology in Jordan. Methodology: The study’s research framework integrates factors from the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT). A questionnaire was distributed to collect data from 372 healthcare professionals in Jordan, and the results were analyzed using structural equation modeling based on the Partial Least Square (PLS) technique. Contribution: While only a few previous studies have explored blockchain technology acceptance in the healthcare sector using either the TAM or the UTAUT, this study uniquely integrates elements from both models, offering a novel approach that provides a comprehensive understanding of the factors that influence the acceptance of blockchain technology among healthcare professionals in Jordan. The findings can assist decision-makers in developing strategies to enhance the adoption rate of blockchain technology in the Jordanian healthcare sector. Findings: The study revealed that usability, convenience, privacy and security, cost, and trust significantly impact the perceived usefulness of blockchain technology. The findings also suggest that healthcare professionals are more likely to have a positive attitude towards blockchain-based healthcare systems if they perceive them as useful and easy to use. Attitude, social influence, and facilitating conditions were found to significantly impact behavioral intention to use. Recommendations for Practitioners: Stakeholders should focus on developing blockchain-based healthcare systems that are easy to use, convenient, efficient, and effort-free. Recommendation for Researchers: Researchers may compare the acceptance of blockchain technology in the healthcare sector with other industries to identify industry-specific factors that may influence adoption. This comparative analysis can contribute to a broader understanding of technology acceptance. Impact on Society: Successful adoption of blockchain technology in the healthcare sector can lead to improved efficiency, enhanced protection of healthcare data, and reduced administrative burdens. This, in turn, can positively impact patient care and lead to cost savings, which contributes to more sustainable and accessible healthcare services. Future Research: Future research may explore integrating blockchain technology with other emerging technologies, such as artificial intelligence and sidechain, to create more comprehensive and innovative healthcare solutions.

A Threat to Sustainable HealthCare Services? Examining the Effect of Structural Violence on the Policy Outcomes of Lagos State Health Insurance Scheme among Enrolled Junior Officers in the Lagos State Ministry of Works and Infrastructure

A Threat to Sustainable HealthCare Services? Examining the Effect of Structural Violence on the Policy Outcomes of Lagos State Health Insurance Scheme among Enrolled Junior Officers in the Lagos State Ministry of Works and Infrastructure

Sustainable Healthcare Resilience: Disaster Preparedness in Saudi Arabia’s Eastern Province Hospitals

In a world increasingly vulnerable to environmental and health crises, sustainable healthcare systems are crucial. This study focuses on the resilience and sustainability of healthcare services in Saudi Arabia’s Eastern Province, assessing their readiness to endure and adapt amidst disaster scenarios. Conducted through a cross-sectional survey involving 522 hospital employees, the research provides an in-depth analysis of various sustainability-related aspects of healthcare preparedness. This includes examining both structural and non-structural safety elements, standard operating procedures, staff training in disaster response, data security, and sustainable management of resources during emergencies. The results reveal a noteworthy commitment to sustainable disaster preparedness: 53.7% of hospitals, predominantly governed by the Ministry of Health, have implemented comprehensive disaster recovery plans. Furthermore, the study found a strong representation of female participants (54.2%) in these hospitals. A significant 64.1% of respondents confirmed the existence of disaster recovery plans in their workplaces, and an even higher percentage, 70.6%, reported receiving specific training in disaster response. These findings underscore the proactive efforts of Eastern Province hospitals in fostering a sustainable and resilient healthcare framework, demonstrating an approach that prioritizes preparedness beyond immediate crisis response. This proactive stance is pivotal in ensuring the continuity of healthcare services amidst the ever-evolving nature of global disasters.

Health Policy and Planning in Health Management System

Health policy and planning play pivotal roles in the effective management of healthcare systems. These aspects encompass the formulation, implementation, and evaluation of strategies and regulations to optimize healthcare delivery. Robust health policies ensure equitable access, quality care, and cost-effectiveness, while planning entails resource allocation, infrastructure development, and workforce distribution. Successful health management systems hinge on evidence-based policies, stakeholder engagement, and adaptability to evolving health challenges. This abstract highlights the critical interplay between policy formulation and strategic planning, emphasizing their indispensable contributions to achieving efficient, accessible, and sustainable healthcare services.

Implementation of Strategic Risk Management in Improving the Quality of Services

Lukasiwan Eddy Saputro. “Implementation of Strategic Risk Management in Improving Service Quality at Ratu Aji Putri Botung Penajam Paser Utara Hospital” (Supervised by. (Nurmadhani Fitri Suyuthi and Sri Adrianti Muin). This study aims to determine the Application of Strategic Risk Management in Improving the Quality of Services of Ratu Aji Putri Botung Hospital Penajam Paser Utara. This research was conducted at Ratu Aji Putri Botung Hospital North Penajam Paser. Data collection was done through observation, interviews, and documentation. This research data was analyzed using qualitative descriptive analysis to answer the formulation of research problems. Descriptive data obtained from observations, interviews, and documentation research will be analyzed. The results of this study found and showed that the Implementation of Strategic Risk Management at Ratu Aji Putri Botung Hospital has been proven to improve the quality of health services by optimizing operational efficiency and improving patient safety. Through risk identification and mitigation, the hospital is able to reduce medical errors and resource shortages. Despite the positive impact, there is room for improvement, such as increased staff training, utilization of information technology, and active involvement of leadership in the risk management process. With these measures, the RSUD can continue to strengthen its risk monitoring and evaluation system to provide higher quality and sustainable healthcare services.

Distress among healthcare professionals during the first two years of COVID-19 pandemic in Portugal

Abstract Background The COVID-19 pandemic increased existing psychosocial risk factors among healthcare professionals (HCPs). Integrated into a wider project, the main objective of this study was to characterize Portuguese HCPs mental health (MH), estimate the percentage of symptoms of anxiety, depression, post-traumatic stress disorder (PTSD), and burnout, and identify risk and protective factors. Methods A cross-sectional online survey and a longitudinal assessment were conducted in 2020 (T0) and 2021 (T1). Sociodemographic and occupational variables, as well as protection behaviors and pandemic-context data were collected from a large non-probabilistic sample of HCPs in Portugal. MH outcomes were assessed using instruments with sound psychometric properties. Risk and protective factors were evaluated through simple and multiple logistic regression models. Results A total of 2027 HCPs participated in the survey in T0; 1843 in T1. Despite the percentage of moderate to severe symptoms had decreased from T0 to T1: 26.1% and 23.3% for anxiety (T0 and T1, respectively; p = 0.028), 25.3% and 23.7% for depression, 22.7% and 19.1% for PTSD (p = 0.003), and 29.8% to 29.5% for burnout, a considerable proportion of HCPs reported symptoms of distress in both years. Being a woman, working in a COVID-19-treatment frontline position and the perception of work-life imbalance increased the odds of distress (in both T0 and T1), whilst high resilience, good social/family support, and hobbies/lifestyle maintenance were found to be MH protective factors. Conclusions The longitudinal approach of our study allowed following-up changes in HCPs mental health and show that performing as an HCP during the pandemic may result in long-term effects on MH. Our results also provide evidence to support interventions targeting gender and professional sub-groups. Further studies are needed to understand the potential long-lasting psychological burden related to COVID-19 among HCPs. Key messages • Our findings are crucial to understand the psychological burden of Portuguese HCPs during the pandemic and to advocate the need of tailored interventions targeting gender and professional sub-groups. • Protecting HCPs mental health by mitigating risks factors and reducing the possibility of long-lasting psychiatric morbidity is paramount to ensure the provision of sustainable healthcare services.

The Environmental Sustainability Assessment of an Orthopedics Emergency Hospital Supported by a New Innovative Framework

Due to their high consumption of resources and enormous amount of generated waste, healthcare systems are not considered to be sustainable. Given the constant changes in internal needs, improvement of this state cannot be achieved only through policies, strategies, and interventions administered from the outside. Thus, it is necessary to design tools that, through their constant application, facilitate the sustainable development of health institutions. The objective of this research is to develop and validate in practice an innovative framework for assessing the sustainability of healthcare facilities that is compatible with hospital accreditation legislation and other community frameworks. The research is limited to the study of environmental sustainability and its results are validated in a healthcare facility with an orthopedic profile. The research method consists of defining the domains of the new innovative framework, collecting the latest medical practices related to environmental sustainability, designing indicators related to environmental responsibility and a matrix of indicators, followed by its validation in practice at an emergency hospital. The new innovative framework is organized in three areas, including environmental, economic, and social sustainability, to which is added organizational capacity along with management and provision of sustainable healthcare services. It contains 57 indicators, of which 8 are dedicated to the environmental area. The indicators are described in detail together with evaluation grids structured by the coupled degrees of importance and achievement. The practical implementation of the innovative framework at the County Emergency Clinical Hospital of Targu Mures highlights its added value by promoting sustainability strategies together with continuous quantification of the organization’s sustainability level.

Driving sustainable healthcare service management in the hospital sector

Sustainability in service management is a crucial issue in today's competitive business environment. Previous researchers have conducted studies on healthcare sustainability from various areas, but none has been conducted on the assessment of driving factors to sustainable service management in the hospital sector. This study fills this research gap by identifying and assessing the driving factors behind sustainable service management in the hospital sector from an emerging economy context. The study does so by utilizing integrated qualitative and quantitative research methods. Primarily, the study performed a Delphi study to identify the most relevant driving factors and then utilized the integrated grey-based decision-making trial and evaluation laboratory (DEMATEL) model to aid the evaluation within the Bangladesh hospital sector. The study identified eleven factors as the causal and nine factors as effect group factors. Furthermore, the factor “Engaging experienced doctors in top management (D20)” was identified as the most prominent driving factor for sustainable hospital service management. The driving factor “Implementation of public health policies (D18)” was identified as the topmost causal factor, and “Proper maintenance and monitoring of hospital support services (D9)” identified as the most influenced/impacted effect group driving factor. The study's findings have significant policy implications for service operations and managers in the hospital sectors. The service managers should give special attention to the causal group driving factors and invest heavily in them as that will help to improve the effect group factors within the system.

Interdisciplinary frontline teams in home-based healthcare services—paradoxes between organisational work structures and the trust model: a qualitative study

BackgroundAchieving access to quality healthcare services to ensure healthy lives and promote well-being for all at all ages is one of the United Nation’s Sustainable Developments Goals. In view of this goal, sustainable community healthcare services in Norway need to be urgently restructured in light of demographic changes, including an increase in the percentage of older adults in the country. National healthcare policies recommend finding new ways to organise and perform services using new technology, new methods and new solutions. The goal is to ensure greater continuity in the provision of services and softer transitions that enable service users to deal with a smaller number of people. The trust model is one such suggested organisational approach. The goal of the trust model is to involve service users and their next of kin in decisions that concern them while also trusting frontline workers’ professional judgement in assessing the need for services and adjusting them to address changes in the health of the users, thus making the services individually tailored and more flexible. This study aims to explore how organisational work structures influence the delivery of interdisciplinary home-based healthcare services.MethodsObservations, individual-, and focus groups interviews were conducted within community home-based healthcare services in a large Norwegian city with managers at different levels, nurses, occupational therapists, physiotherapists, purchaser-unit employees and other healthcare workers. Data was analysed thematically.ResultsThe results are presented in terms of themes— “Balancing on the margins: Negotiations between the time available, users’ needs, unforeseen events and administrative tasks” and “One gathered unit, but with different work structures”. The results identify organisational work structures that influence the performance of the trust model with regard to its intention of making flexible and individually tailored services available. However, these structures are different for the members of the interdisciplinary team, thus creating several paradoxes that need to be negotiated while fulfilling their daily responsibilities.ConclusionThis study suggests that it is crucial to pay attention to paradoxes and structures experienced by interdisciplinary frontline workers in home-based healthcare services, since they are unavoidable factors that need to be acknowledged when designing approaches for addressing the changes expected in community healthcare services.

Assessment of Labor Practices in Healthcare Using an Innovatory Framework for Sustainability.

Background and Objectives: The concept of sustainability in healthcare is poorly researched. There is a perceived need for new theoretical and empirical studies, as well as for new instruments to assess the implementation of new labor practices in the field. Such practices address unmet social needs and consolidate the sustainable development systems which promote health equity. The objective of the research is to design an innovative reference framework for sustainable development and health equity of healthcare facilities, and to provide a practical validation of this framework. Materials and Methods: The research methods consist of designing the elements of the new frame of reference, designing an indicator matrix, elaborating indicator content, and assessing the reference framework. For the assessment stage, we used sustainable medical practices reported in the scientific literature as well as a pilot reference framework that was implemented in healthcare practice. Results: The new reference framework suggested by the present study is composed of 57 indicators organized in five areas: environmental responsibility, economic performance, social responsibility, institutional capacity, and provision of sustainable healthcare services. These indicators were adapted and integrated into the seven basic topics of the social responsibility standard. The study presents the content of the indicators in the field of labor practices, as well as their evaluation grids. The innovative format of the evaluation grids aims to describe achievement degrees, both qualitatively and quantitatively. The theoretical model was validated in practice through its implementation at the Emergency Hospital in Targu Mures. Conclusions: The conclusions of the study reflect the usefulness of the new reference framework, which is compatible with the requirements in the healthcare field, but differs from other existing frameworks, considering its objective regarding the promotion of sustainable development. This objective facilitates the continuous quantification of the sustainability level, the promotion of sustainable development strategies, and sustainability-oriented approaches on the part of interested parties.

Job Satisfaction among Occupational Therapists Employed in Primary Care Services in Norway.

The aging population will place healthcare services under considerable strain in the years ahead. Occupational therapists play a vital role in securing sustainable healthcare services and are increasingly employed by municipalities. To promote sustainable services, the job satisfaction among core professional groups needs monitoring. A comprehensive cross-sectional survey was distributed among municipality-employed occupational therapists in Norway during May-June 2022, to which 617 responded. Job satisfaction was assessed with the Job Satisfaction Scale (JSS), and factors associated with job satisfaction were assessed with linear regression analysis. The mean JSS score in the sample was 51.4. The regression model explained 14.4% of the variance in job satisfaction scores. Having more work experience as an occupational therapist (β = 0.16, p = 0.02) and having higher perceived influence on the work unit's goals (β = 0.31, p < 0.001) were significantly related to higher job satisfaction. The study implies that job satisfaction in the occupational therapy profession increases with years of experience and also with the ability to engage with and influence the larger work environment. Thus, to promote job satisfaction, occupational therapists should seek to engage not only with their own work at hand but also with the larger goals and strategies of the organization they work for.

Does increasing the number of beds or health workers contribute to the rational use of scarce public health resources?

Turkey makes substantial investments to increase the number of qualified beds in hospitals, the shortage in health professionals remains one of the main obstacles of the health system in the country. To address this research gap, the study aims to formulate a rational solution for the dilemma on whether to invest in beds or health professionals contribute to the rational use of scarce public health resources. Data for testing the model were derived from the Turkish Statistical Institute across 81 provinces in Turkey. The path analytic approach was used to determine the associations among hospital size, utilization/facility, health workforce, and indicators of health outcomes. The results point to a strong link between quantity of qualified beds, utilization of health services, and facility indicators, and health workforce. Rational use of scarce resources, optimal capacity planning, and increased quantity of health professionals will be beneficial for the sustainability of health care services.